PROJECT DESCRIPTION BurntOut: Role-Play Simulation for Building Medical Student Resiliency Medical student and physician burnout rates are high. Rates correlate with alcohol and other substance use problems, and negatively impact patient care. This project will create a 3D simulation BurntOut: Role- Play Simulation for medical students to practice and respond to stressful situations, enhance coping, and develop ways to respond that decrease use of unhealthy behaviors such as alcohol misuse. During Phase I, we created and evaluated a prototype simulation. We conducted needs analysis to identify stresses, associated impact on clinical medicine, research-based interventions, and assessment tools based on literature review, faculty consultation, and formative analysis. We created a design document for the simulation focused on exposing students to challenges associated with clinical care and highlighting well-being resources. The document outlines a strategy to expand coping skills, counter the misuse of alcohol and other substances, decrease depression, build resiliency, and decrease burnout during their clinical training and future career. After creating a proof of concept prototype, we conducted iterative rounds of formative analysis and revision. Dr. Tanner also presented the work at the International Conference on Physician Health and received significant positive feedback. The approach was well received as a unique and valuable contribution; they provided guidance as well. In Phase II, we will complete development incorporating frequent and regular input from a variety of stakeholders. Adopting the role of a medical student character in the simulation, students can engage challenges and conflicts, make decisions to avoid stress or use coping strategies, enhance their resiliency, and experience the impact of their choices. The final interactive experience will include: 1. 20 short scenarios, lasting 5-15 minutes, in simulated hospital, clinic, home, and wellness environments. 2. A simulated break room with a computer-generated peer/mentor character providing guidance to support lessons learned and to assist in setting goals to apply to real world choices and behaviors. 3. A tailored resource guide based on the break room experience that provides direction to online, institutional, and organizational resources and support. Examples include mindfulness training opportunities, exercise/diet/sleep tips, wellness centers, and popular student communication boards run by respected organizations. Usability and pilot testing will ensure the final product and evaluation design has maximum potential for success. A final summative study will be a randomized pre/post, wait-list control evaluation with 80 students (40/group) and a 3 month follow up. We will assess impact on burnout symptoms, quality of life, resiliency, alcohol use, depression, and product satisfaction using standardized scales. The above work will determine the potential of a 3D simulation to enable medical students to build resiliency by practicing decision making, deploying beneficial coping skills, rejecting alcohol and substance-based coping strategies, reducing depression, and decreasing burnout.